The explanation of this paralysis of the Central Authority, as regards the policy to be pursued with persons of unsound mind, is to be found, we believe, in the existence and growth during this period of the rival authority of the Lunacy Commissioners, who had authority over all persons of unsound mind, whether paupers or not. The Lunacy Commissioners had not habitually in their minds the principle of "less eligibility"; and they were already, between 1848 and 1871, making requirements with regard to the accommodation and treatment of pauper lunatics that the Poor Law authorities regarded as preposterously extravagant. The records of the boards of guardians show visits of the inspectors of the Lunacy Commissioners, and their perpetual complaints of the presence of lunatics and idiots in the workhouses without proper accommodation; mixed up with the sane inmates to the great discomfort of both;[408] living in rooms which the Lunacy Commissioners considered too low and unventilated, with yards too small and depressing, amid too much confusion and disorder, for the section of the paupers for whom they were responsible.[409] Such reports, officially communicated to the Poor Law Board, seem to have been merely forwarded for the consideration of the board of guardians concerned. But other action was not altogether wanting. Under pressure from the Lunacy Commissioners, the Central Authority asked, in 1857, for more care in the conveyance of lunatics;[410] urged, in 1863, a more liberal dietary for lunatics in workhouses;[411] in 1867 it reminded the boards of guardians that lunatics required much food, especially milk and meat;[412] it was thought "very desirable that the insane inmates ... should have the opportunity of taking exercise";[413] it concurred "with the Visiting Commissioner in deeming it desirable that a competent paid nurse should be appointed for the lunatic ward," in a certain workhouse;[414] it suggested the provision of leaning chairs in another workhouse;[415] and, in yet another, the desirability of not excluding the persons of unsound mind from religious services.[416] In 1870 it issued a circular, transmitting the rules made by the Lunacy Commissioners as to the method of bathing lunatics, for the careful consideration of the boards of guardians.[417] But we do not find that the Central Authority issued any Order amending the General Consolidated Order of 1847, which, it will be remembered, did not include among its categories for classification either lunatics, idiots, or the mentally defective; and the Central Authority did not require any special provision to be made for them.
The policy of the Lunacy Commissioners was to get provision made in every county for all the persons of unsound mind, whatever their means, in specially organised lunatic asylums in which the best possible arrangements should be made for their treatment and cure irrespective of cost, and altogether regardless of making the condition of the pauper lunatic less eligible than that of the poorest independent labourer. Unlike the provision for education, and that for infectious disease, the cost of this national (and as we may say communistic) provision for lunatics was a charge upon the poor rate. Under the older statutes, the expense of maintaining the inmates of the county lunatic asylums was charged to the Poor Law authorities of the parishes in which they were respectively settled; and the boards of guardians were entitled to recover it, or part of it, from any relatives liable to maintain such paupers, even in cases in which the removal to the asylum was compulsory and insisted on in the public interest.[418] The great cost to the poor rate of lunatics sent to the county lunatic asylums, and the difficulty of recovering the amount from their relatives, prevented the whole-hearted adoption, either by the boards of guardians, or the Central Authority, of the policy of insisting on the removal of persons of unsound mind to the county asylums. For the imbeciles and idiots of the Metropolitan Unions, provision was made after 1867 in the asylums of the Metropolitan Asylums Board.[419] But no analogous provision for those of other unions was made. The result was that, amid a great increase of pauper lunacy, the proportion of the paupers of unsound mind who were in lunatic asylums did not increase.[420] On the other hand the indisposition of the Central Authority to so amend the General Consolidated Order of 1847 as to put lunatics in a separate category, and require suitable accommodation and treatment for them—an indisposition perhaps strengthened by the very high requirements on which the Lunacy Commissioners would have insisted—stood in the way of any candid recognition of the fact that for thousands of lunatics, idiots, and mentally defectives, the workhouse had, without suitable provision for them, and often to the unspeakable discomfort of the other inmates, become a permanent home.
During this period, the blind, the deaf and dumb, and the lame and deformed were increasingly recognised by Parliament as classes for whom the Poor Law authorities might, if they chose, provide expensive treatment. This was done by authorising boards of guardians, if they chose, to pay for their maintenance, whether children or adults, in special institutions.[421] We do not find that the Central Authority suggested the adoption of this or any other policy or gave any lead to the boards of guardians with regard to these cases.[422]
We have shown that neither the Report of 1834 nor the Central Authority between 1834 and 1847 even suggested any departure from the common practice of granting outdoor relief to the aged and infirm. This continued, so far as the official documents show, to be the policy of the Central Authority during the whole of the period 1847-1871.[423] The only two references to the subject in the Orders and Circulars of this period assume that the aged and infirm will normally be relieved in their own homes. Thus, in 1852, in commenting on the provision requiring the weekly payment of relief, the Central Authority said, "as to the cases in which the pauper is too infirm to come every week for the relief, it is on many accounts advantageous that the relieving officer should, as far as possible, himself visit the pauper, and give the relief at least weekly."[424] And in the first edition of the Out-relief Regulation Order of 1852 (that of 25th August 1852) the Central Authority, far from prohibiting outdoor relief to persons "indigent and helpless from age, sickness, accident, or bodily or mental infirmity," formally sanctioned this practice, by ordering that "one third at least of such relief" should be given in kind (viz., "in articles of food or fuel, or in other articles of absolute necessity"),[425] the object being expressly explained to be, not, as might nowadays have been imagined, the discouragement of such relief, but the prevention of its misappropriation.[426] This provision was objected to by boards of guardians up and down the country, on the ground that it would be a hardship to the aged and infirm poor. The Poplar Board of Guardians, for instance, stated "that there are a large number of persons under the denomination of aged and infirm whom the guardians have, in their long practical experience, found it expedient and not objectionable to relieve wholly in money, feeling assured that it would be beneficially expended for their use, and that in consequence of their infirmity the relieving officer or his assistant, if necessary, is thereby enabled to conveniently relieve them at their own house."[427] The Norwich Guardians stated that it would be difficult "to determine (especially for the aged and sick poor) what kind of food or articles should be given." They also communicated with forty other unions, summoning them to concerted resistance.[428] A deputation "from most of the large and populous unions in the north of England ... and from several Metropolitan parishes, representing in the aggregate upwards of 2,000,000 of population,"[429] assembled in London, and objected to nearly all the provisions of the Order.
Accompanied by about twenty-five members of Parliament, the deputation waited on the Poor Law Board, and specially urged their objection to being compelled to give a third of all outdoor relief in kind. After two hours' argumentative discussion, Sir John Trollope said that the board would reconsider the whole Order, which need not in the meantime be acted upon; and he hinted at a probable modification of the Article relating to relief in kind.[430] In response to these objections, the Central Authority does not seem even to have suggested that outdoor relief to the aged and infirm was contrary to its principles. It first intimated its willingness to modify the Order if its working proved to be "accompanied with hardship to the aged or helpless poor"[431] and then within a few weeks withdrew the provision altogether as regards any but the able-bodied.[432] It was expressly explained that the Order, as re-issued, was intended as a precaution "against the injurious consequences of maintaining out of the poor rate able-bodied labourers and their families in a state of idleness," and that the Central Authority left to the boards of guardians "full discretion as to the description of relief to be given to indigent poor of every other class."[433] From that date down to the abolition of the Poor Law Board in 1871, we can find in the documents no hint or suggestion that it disapproved of outdoor relief to the aged and infirm. On 1st January 1871, nearly half the outdoor relief was due to this cause.[434]
There was no change in the policy of preventing relief to paupers not resident within the union. The Outdoor Relief Regulation Order of 1852 embodied the prohibition with the same exceptions as had been contained in the Outdoor Relief Prohibitory Order of 1844, omitting, however, that of widows without children during the first six months of their widowhood. But, as has been already mentioned, at the very end of the period the Boarding-Out Orders of 1869, etc., permitted children to be maintained outside the union.